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(1) DOCTORS
ARE NOT GOOD AT GOING TO SEE THEIR
OWN DOCTOR!
(2) WOMEN
IN ETHNIC MINORITIES MAY BE MISSING
BENEFITS
OF HRT
(1) DOCTORS ARE NOT
GOOD AT GOING TO SEE THEIR
OWN DOCTOR!
(Doctors as patients: postal survey
examining consultants and
general practitioners adherence
to guidelines)
http://www.bmj.com/cgi/content/full/319/7210/605
Most senior doctors (both general practitioners
and consultants)
rarely go to see their primary care doctor
and for many (over 70
per cent) prescribing for themselves and
their families is the norm,
according to a study published in this
week's BMJ. What is
needed to address doctor's health problems,
say the authors from
the University of Kent, is access to a
"doctor's doctor", possibly
based in the local hospital, who could
also look after other NHS
staff and their families; an occupational
health service for general
practitioners (GPs) and regular health
check ups for all doctors.
Professor Malcolm Forsythe and colleagues
studied the personal
use of health services of over 1150 GPs
and consultants in south
east England, in accordance with the BMA
guidelines on the
ethical responsibilities of doctors towards
themselves and their
families. The study, say the authors,
was conducted in the context
of a current picture of GPs and senior
hospital doctors with high
levels of stress, anxiety and depression
who take little time off
work for illness but who, when they are
off work, tend to be off
for long periods.
Forsythe et al found that even though most
(96 per cent) doctors
were registered with a GP they very rarely
used their services. The
team also found that doctors were very
reluctant to take time off
work due to illness and that this was
particularly true of GPs and
female doctors. Despite their findings
the authors also report that
doctors expressed support of the BMA guidance
on their
responsibilities to their own health and
that of their families.
The authors suggest that one of the reasons
doctors are unlikely to
consult their own GP is because of difficulties
of getting to see
them. They also say that with the high
levels of psychosocial
problems among doctors, visiting their
GP or local occupational
health service may not be perceived by
doctor patients as the
appropriate confidential setting for consultation.
Forsythe et al conclude that there is a
need for the provision of a
dedicated general practitioner service
for doctors and their
families, as well as an "out of area"
(ie not within the same
workplace) service, particularly for the
treatment of psychosocial
problems and substance misuse. They say
that these changes
together with provision of a consultant
led occupational service to
cover all NHS staff, may improve compliance
with the ethical
guidelines covering this area.
Contact:
Professor Malcolm Forsythe, Professorial
Fellow in Public Health,
Centre for Health Services Studies, George
Allen Wing, University
of Kent, Canterbury, Kent
Email: J.M.Forsythe-2@ukc.ac.uk
(2) WOMEN IN ETHNIC
MINORITIES MAY BE MISSING
BENEFITS OF HRT
(Ethnic differences in use of hormone
replacement therapy:
community based survey)
http://www.bmj.com/cgi/content/full/319/7210/610
Women of south Asian origin living in the
UK are at increased risk
of coronary heart disease and osteoporosis
and yet they are less
likely than white women to use hormone
replacement therapy
(HRT), despite it being widely promoted
as preventing these
conditions, report a team from St George's
Hospital Medical
School in this week's BMJ.
Dr Tess Harris et al studied 882 white,
African and South Asian
women aged 40-59 living in south London.
White women were
more than twice as likely to be HRT users
compared to South
Asian women (25% versus 10%) whereas women
of Caribbean
or West African descent were intermediate
in their use of HRT
(15%) say the authors. The differences
in HRT use between ethnic
groups were not explained by differences
in other factors
influencing HRT use including age and
hysterectomy rates, they
say.
Harris et al claim that their findings
are potentially important
because of the possible long term protective
effects on heart and
bone, which may particularly benefit South
Asian women with their
raised risk of coronary heart disease
and osteoporosis. They
conclude that opportunities for health
promotion amongst women
from ethnic minorities may be being missed
and that further work
to explore the reasons for the differences
is needed.
Contact:
Professor Derek Cook, Department of Public
Health Sciences, St
George's Hospital Medical School, London
Email: d.cook@sghms.ac.uk
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